Payors Covering Home Care Services

Payors Covering Home Care Services

JASACare works with several payor options:

  • Medicaid
  • Medicare
  • Private pay

 

Payors Covering Home Care Services

 

  • Medicaid. Covers long-term care for seniors 65+ and disabled individuals. The services can be paid for by an MLTC or an MCO insurance payor. MCO services are based on 90-day authorization and need to be re-authorized with a new M11Q from a primary care physician. However, the MLTC usually provides clients with a yearly authorization. Typically, no reauthorization is required for services. In both cases, clients might request additional hours based on deterioration in their medical condition. Our team helps our clients to obtain additional hours should there be significant changes in condition.

     

  • Medicare. Clients that have Medicare could qualify for short-term home care services. Typically, these services are for up to 120 days. However, these clients will need a clinical need, and the services must be contracted through the CHHA, who typically provides the clinical services, while we will provide the home care services. Our team understands that Medicare services are for the short-term; as such, for clients that require long-term care, we support those that could qualify to apply for Medicaid and, if needed, connect them with our partners that can help them to set up a supplemental needs trust and a pooled trust.

     

  • Private pay. All clients can pay out of pocket for service or through private-long term care insurance.